<%@ Control Language="VB" AutoEventWireup="false" CodeFile="CInfo_Other.ascx.vb" Inherits="WebForms_CInfo_Other" %>
<%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="ajaxToolkit" %>

<div id="divMain" runat="server">
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px;height: 5px;"></td></tr>
    </table>
    
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr>
        <td id="Policy_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
            
        </td>
        <td></td>
        </tr>
        <tr>
        <td id="Provider_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
            Friends Provident - Premiere
        </td>
        <td align="right" style="font-weight: bold; font-size: 10pt; font-family: Arial; color: #d63007;">
            Add New Individual
        </td>
        </tr>
    </table>

    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr><td style="font-size: 3px; background-color: #105BA4; height: 3px;"></td></tr>
    </table>
    
    <table border="0" cellpadding="0" cellspacing="0" width="800">
        <tr>
        <td ID="Name_td" runat="server" align="left" style="font-weight: bold; font-size: 10pt; font-family: Arial;">
            
        </td>
        </tr>
    </table>
    
    <br />

    <table border="0" cellpadding="0" cellspacing="0" width="800">
    
    <tr>
    <!-- Start Menu -->
    <td style="width: 200px" valign="top">
    
        <table border="0" cellpadding="0" cellspacing="0" width="100%">
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Main_Info_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Main Information&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/redT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Other_Info_btn" runat="server" Font-Underline="False" 
                    ForeColor="Black" CausesValidation="False">Other Information&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Correspondence_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Correspondence&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Attachments_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Attachments&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>
        <tr>
            <td style="height: 30px"><img src="../images/grayT.PNG" alt="selected" />
            </td>
            <td style="font-weight: bold; font-size: 10pt; font-family: Arial; width: 180px; height: 30px;" align="right">
            <asp:LinkButton ID="Risk_Profile_btn" runat="server" Font-Underline="False" 
                    ForeColor="#999999" CausesValidation="False">Risk Profile&nbsp;&nbsp;</asp:LinkButton>
            </td>
        </tr>        
        </table>
    
    </td>
    <!-- End Menu -->
    
    <!-- Start Content -->
    <td style="width: 600px">
    
        <table border="0" cellpadding="0" cellspacing="0" width="100%" style="background-color: #f2f3f5">
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left"></td>
            </tr>
            </table>
        </td></tr>        

        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Occupation:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:TextBox ID="Occupation_txt" runat="server" Width="135px"></asp:TextBox>
                </td>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Position:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:TextBox ID="Position_txt" runat="server" Width="135px"></asp:TextBox></td>
            </tr>
            </table>
            
        </td></tr>

        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Nature of Business:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:TextBox ID="business_nature_txt" runat="server" Width="135px"></asp:TextBox></td>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Other/Remarks:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:TextBox ID="Remarks_txt" runat="server" Width="135px"></asp:TextBox></td>
            </tr>
            </table>
            
        </td></tr>
        
        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;ID Type:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:DropDownList ID="IDType_cmb" runat="server" Width="135px">
                    </asp:DropDownList></td>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;ID Number:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:TextBox ID="IDNo_txt" runat="server" Width="135px"></asp:TextBox></td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td>
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Smoking Status:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:DropDownList ID="SmokingStatus_cmd" runat="server" Width="135px">
                </asp:DropDownList></td>
                <td style="font-size: 10pt; font-family: Verdana; width: 25%; height: 28px;" align="left">
                    &nbsp;Source of&nbsp; Funds:</td>
                <td style="width: 25%; height: 28px; font-size: 10pt; font-family: Verdana;" align="left">
                    <asp:DropDownList ID="Funds_cmb" runat="server" Width="135px">
                    </asp:DropDownList></td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 152px; height: 28px;" align="left">
                    &nbsp;</td>
                <td style="width: 448px; height: 28px" align="left">
                    </td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left"></td>
            </tr>
            </table>
        </td></tr>                
        </table> 
            
        <table border="0" cellpadding="0" cellspacing="0" width="100%" style="background-color: #f2f3f5">
        <tr><td>
        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 107px;" align="left">
                    </td>
                <td style="width: 190px"></td>
                <td style="width: 150px" align="center"><asp:Button ID="Save_btn" runat="server" Text="Save" 
                    BackColor="Gainsboro" Font-Names="Verdana" Width="80px" /></td>
                <td style="width: 150px" align="center"><asp:Button ID="Cancel_btn" runat="server" Text="Back" 
                    BackColor="Gainsboro" Font-Names="Verdana" Width="80px" CausesValidation="False" /></td>
            </tr>
            </table>
            
        </td></tr>
        <tr><td>        
            <table border="0" cellpadding="0" cellspacing="0" width="100%">
            <tr>
                <td style="font-size: 10pt; font-family: Verdana; width: 110px; height: 10px;" align="left"></td>
            </tr>
            </table>
        </td></tr>        
        </table>             
    </td>
    <!-- End Content --></tr>
    
    </table>        
</div>
